What to do if you have a heavy nosebleed

Nosebleed is something that many people have experienced. There are many reasons for nosebleed. Due to the different physical conditions of each person, the causes of nosebleed may not be exactly the same, and the symptoms that occur during nosebleed may not be exactly the same. Some people only have a little nosebleed and it goes away, while others have a lot of nosebleed. When a lot of nosebleed occurs, you must stop the nosebleed in time or go to the hospital for treatment.

What to do if you have a heavy nosebleed

1. Oppression Law:

Use the fingers of one hand to pinch one or both nostrils tightly to the nasal septum to stop the bleeding.

2. Cold compress method:

You can apply an ice pack or a towel soaked in cold water to the patient's forehead and back of the neck. When the blood encounters the cold stimulation, it will flow slowly, thereby achieving the purpose of stopping bleeding.

3. Guidance method:

Instruct the patient to soak his feet in warm water, or apply mashed garlic and gardenia to the soles of the feet to guide the heat downward, reduce inflammation, and achieve the purpose of hemostasis.

4. Packing method:

Place a hemostatic drug on a cotton pad or cotton strip and stuff it into the nasal cavity on the affected side to achieve the purpose of stopping bleeding. When you have a nosebleed, you must stay calm, sit upright, tilt your head forward slightly, apply ice packs to your forehead and back of the neck, or pinch your nose with the thumb and index finger of one hand to turn the nose up for about 5-10 minutes to stop the bleeding as soon as possible. If the bleeding does not stop, seek medical treatment as soon as possible.

Causes of Nosebleeds

1. Local causes

(1) Nasal injury

① Mechanical trauma such as car accidents, falls, boxing injuries and nose picking are common causes of epistaxis.

② Barotraumatic injury: During high-altitude flying or diving, if the air pressure difference inside and outside the sinuses changes too much suddenly, the blood vessels in the mucosa of the nasal cavity and sinuses will dilate, rupture and bleed.

③Radiotherapy injury During and after radiotherapy of the head and neck, the nasal mucosa becomes congested and edematous, or the epithelium falls off, and epistaxis may also occur.

(2) Nasal septum deviation

It often occurs near the bony ridge or spine (rectiform process) or the convex surface of the deviated nasal septum. The mucosa there is thinner and the direction of air flow changes here, so the mucosa becomes dry, causing blood vessels to rupture and bleed. Patients with nasal septum perforation may suffer from recurrent epistaxis due to dryness, erosion, and shedding of the mucosa at the edge of the perforation.

(3) Nasal inflammation

① Non-specific inflammation of the nose such as acute rhinosinusitis, dry rhinitis, atrophic rhinitis, etc. can easily cause epistaxis, but the amount of bleeding is generally not much.

② Specific infections of the nose such as tuberculosis, lupus, syphilis, leprosy and diphtheria can cause epistaxis due to mucosal erosion, ulcers, granulation tissue and nasal septum perforation.

(4) Tumors of the nasal cavity, paranasal sinuses, and nasopharynx

Among them, the most likely to cause epistaxis are nasal septum hemangioma, nasopharyngeal angiofibroma, hemorrhagic nasal polyps and malignant tumors of the nasal cavity and paranasal sinuses. Minor nose bleeding or blood in the mucus is one of the main early symptoms of malignant tumors.

(5) Foreign body in the nasal cavity

It is common in children, mostly unilateral nasal bleeding, because foreign objects remain in the nasal cavity for a long time, which can cause erosion and bleeding of the nasal mucosa. Animal foreign bodies in the nasal cavity, such as leeches, can cause repeated heavy nosebleeds.

2. Systemic causes

(1) Bleeding diseases and blood diseases

① Diseases with defects in the structure and function of the vascular wall such as hereditary hemorrhagic telangiectasia, vitamin C deficiency, allergic purpura, drug-induced vascular purpura, infectious vascular purpura, von Willebrand disease, etc.

② Diseases with platelet quantity or function disorders such as idiopathic thrombocytopenic purpura, secondary thrombocytopenia caused by various reasons, etc.

③Coagulation factor disorders such as various types of hemophilia, vitamin K deficiency, etc.

④ The blood's own anticoagulant effect is too strong, such as improper use of anticoagulants, the presence of anticoagulant substances such as antifibrinogen in the blood circulation, or excessive or accelerated fibrinolysis, such as disseminated intravascular coagulation.

(2) Acute febrile infectious diseases

Such as cold, influenza, hemorrhagic fever, scarlet fever, malaria, measles and typhoid. It is mostly caused by high fever, toxic damage to blood vessels, congestion, swelling and dryness of the nasal mucosa, resulting in rupture and bleeding of capillaries. Generally, the amount of bleeding is small, mostly occurs during the fever period, and the bleeding site is mostly located in the front of the nasal cavity.

(3) Cardiovascular system diseases

① Hypertension and arteriosclerosis Hypertension and arteriosclerosis are important causes of nosebleeds in middle-aged and elderly people, and vascular sclerosis is its pathological basis. Increased blood pressure, especially when constipated, overexerting or emotionally excited, can rupture blood vessels in the nose and cause nosebleeds. In addition, sneezing, coughing hard, vigorous nasal breathing or nasal massage are also factors that cause nosebleeds to recur and become difficult to control.

② Increased venous pressure due to diseases such as emphysema, cor pulmonale, mitral valve stenosis, and space-occupying lesions in the neck or mediastinum can cause superior vena cava hypertension. The nasal cavity and nasopharyngeal veins of these patients are often distended and congested. When the patient coughs violently or due to other inducements, the blood vessels may rupture and bleed. The bleeding site is mostly located in the distribution area of ​​the nasopharyngeal vein at the posterior nostril.

(4) Other systemic diseases

Pregnancy, premenopause, and menopause can all cause epistaxis, which may be related to increased capillary fragility. Patients with severe liver disease may experience epistaxis due to impaired liver synthesis of coagulation factors. Uremia can also cause epistaxis. Epistaxis can be one of the early manifestations of rheumatic fever.